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Differences in the Occurrence and Characteristics of Injuries Between Full- Time and Part-Time Dancers

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Differences in the Occurrence and Characteristics of Injuries Between Full- Time and Part-Time Dancers BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2017-000324 on 21 March 2018. Downloaded from Open Access Original article Differences in the occurrence and characteristics of injuries between full- time and part-time dancers Amy Jo Vassallo,1,2,3 Evangelos Pappas,1 Emmanuel Stamatakis,2,3 Claire E Hiller1 To cite: Vassallo AJ, Pappas E, ABSTRACT What are the new findings? Stamatakis E, et al. Differences Background Professional dancers are at significant in the occurrence and risk of injury due to the physical demands of their career. characteristics of injuries ► A substantial proportion of part-time dancers Despite their high numbers, the experience of injury in between full-time and part- experience injuries, despite a relatively low load of freelance or part-time dancers is not well understood. time dancers. BMJ Open dance compared with full-time dancers. Sport & Exercise Medicine Therefore, the aim of this study was to examine the ► Fatigue is the most commonly cited contributor to 2018;4:e000324. doi:10.1136/ occurrence and characteristics of injury in part-time injury by both full-time and part-time dancers. bmjsem-2017-000324 compared with full-time Australian professional dancers. ► A typical week of dance activity (or dance exposure) Methods Data were collected using a cross-sectional Additional material is was difficult for part-time and freelance dancers to ► survey distributed to employees of small and large dance published online only. To view report on, and this must be taken into consideration companies and freelance dancers in Australia. Statistical please visit the journal online when designing future studies for the standardisation comparisons between full-time and part-time dancer (http:// dx. doi. org/ 10. 1136/ of reporting dance injury research. bmjsem- 2017- 000324). demographics, dance training, injury prevalence and ► Over 50% of injured part-time dancers seek care characteristics were made using 2, two-tailed Fisher’s χ from clinicians outside of their dance employment, exact tests, independent t-tests and Mann-Whitney U tests. who may require tailored education and support Accepted 20 February 2018 Results A total of 89 full-time and 57 part-time dancers to practically advise on dance modifications while were included for analysis. A higher proportion of managing an injury. by copyright. full-time dancers (79.8%) than part-time dancers (63.2%) experienced an injury that impacted on their ability to dance in the past 12 months (p=0.035). Injuries Injuries sustained during one’s dance career characteristics were similar between groups with fatigue can have significant consequences, both on being the most cited contributing factor. Part-time dancers ability to maintain fulfilling dance employ- took longer to seek treatment while a higher proportion ment, as well as other aspects of a dancer’s of full-time dancers were unable to dance in any capacity 6 following their injury. daily life and identity. Therefore, there is an Conclusion More full-time dancers sustained an increasing focus within the dance commu- injury in the past 12 months, and were unable to nity on developing a better understanding of dance in any capacity following their injury. However dance-related injuries, their causes, preven- http://bmjopensem.bmj.com/ injuries still commonly occurred in part-time dancers tion and management. without necessarily a large volume of dance activity. Comprehensive and regular collection of Part-time dancers often access general community descriptive epidemiological data is an essen- clinicians for treatment, who may need additional tial part of the injury prevention process.7 education to practically advise on appropriate return The majority of epidemiological studies to dance. within the dance literature investigate inju- ries in full-time dancers, who work within the support structures of large and well-re- sourced companies, and predominantly on September 28, 2021 by guest. Protected 8 1 INTRODUCTION practise ballet or contemporary dance. Only Faculty of Health Sciences, University of Sydney, Sydney, Professional dance can be a rewarding, a small percentage of dancers, however, are New South Wales, Australia yet physically challenging career path. employed by large companies. In Australia, 2Charles Perkins Centre, Dancers place enormous physical demands for example, of the approximate 1135 profes- University of Sydney, Sydney, on their bodies as they take class, rehearse, sional dancers and choreographers,9 it is New South Wales, Australia 3 perform, tour and compete for a limited estimated that less than 200 are employed Sydney School of Public Health, University of Sydney, Sydney, number of paid positions within the profes- with full-time (or near to full-time) contracts 1 10 New South Wales, Australia sional dance industry. The incorporation with a major company. Another study of strong artistic,2 aesthetic3 and perfection- from 2009 found that only one Australian 4 5 Correspondence to istic components in dance performance non-major performing company was able to Amy Jo Vassallo; is also proposed to contribute to a unique offer year-round or full-time employment to avas0473@ uni. sydney. edu. au risk, distribution and experience of injury. dancers.10 11 This is not an issue exclusive to Vassallo AJ, et al. BMJ Open Sport Exerc Med 2018;4:e000324. doi:10.1136/bmjsem-2017-000324 1 BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2017-000324 on 21 March 2018. Downloaded from Open Access Australia, as a 2001 English study also identified only professional dancer was defined as a person aged over approximately 10% of paid dance positions were year- 18 years, who was paid to work, rehearse or perform as a long contracts.10 12 dancer in Australia for a combined period of 3 months or Since the time of these studies there have been further more over the past 12 months, and who personally iden- changes to the professional dance landscape in Australia, tified primarily as a professional dancer. A dance-related as the nature of dance employment and performance has injury was defined as a physical problem deriving from continued to diversify.13 14 Now there is a greater variety in stress or other causes to do with performance, rehearsal, dance styles performed professionally, a greater number training, touring or other circumstances of dance life, of very small or temporary companies and increasing flex- which affects ability to participate fully in normal dance ibility in funding options for individual freelance dance training, performance or physical activity.20 A strain was artists.15 This increased diversity also relates to the envi- an injury to a tendon or muscle and a sprain was defined ronments dancers train, rehearse and perform in, which as a stretch or tear to a ligament.22 Full-time dancers would potentially influence dance injury rates,1 16 as well were defined as those who were employed or contracted as the injury prevention and rehabilitation support avail- to work, rehearse or perform as a dancer for at least 48 able to part-time dancers compared with their full-time weeks out of the past 12 months. Dancers meeting the colleagues. overall study inclusion criteria but were employed for Despite their high numbers, freelance or part-time less than 48 weeks of the past 12 months were considered dancers are an understudied population and their expe- part-time dancers. When answering the injury-related rience of injury is not well understood. Additionally parts of the questionnaire, dancers were instructed to there have been no previous national Australian studies focus on the one injury sustained in the past 12 months that incorporate freelance dancers.17 18 Developing a that was most significant to them. better understanding of injuries in part-time dancers, in comparison to full-time dancers, will address this Statistical analysis gap. Therefore, the aim of this study was to examine the All data analysis was conducted in IBM SPSS Statistics for occurrence and characteristics of musculoskeletal injury Windows (V.22). Statistical significance was set a priori in full-time compared with part-time Australian profes- p<0.05. 2 sional dancers. χ or two-tailed Fisher’s exact tests were used to test for statistical differences between dance employment status by copyright. METHODS (full time or part time) and demographic characteris- This study utilised data collected from Safe Dance IV,19 a tics, dance experience, injury characteristics and injury cross-sectional survey of professional dancers in Australia contributors. Independent t-tests were used to determine undertaken in 2016–2017. statistical differences between dance employment status and normally distributed continuous variables, including Questionnaire development, dissemination and variable age, body mass index and years of dance employment. definitions Mann-Whitney U tests were used to determine differ- The Safe Dance IV questionnaire was developed based on ences between dance employment status and continuous previous studies from 198917 to 1999,18 the Fit to Dance ordinal data that were not normally distributed, including http://bmjopensem.bmj.com/ 2 survey20 from the UK, a literature review and advice number of dance hours, number of injuries sustained, from key stakeholders, including current and recently number of days taken to seek clinical care and days to retired professional dancers, dance physiotherapists and return to dance. peak bodies. The questionnaire included components on dancer demographics, early dance training and current RESULTS dance working environments, occurrence of injury in the A total of 146 surveys were included that met the profes- past 12 months, injury sites and types, possible contrib- sional dancer inclusion criteria and completed all uting factors, injury management and healthcare access relevant injury-related questions for this study objective. and return dance practices. The questionnaire predom- There were 57 part-time and 89 full-time dancers, table 1 on September 28, 2021 by guest.
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